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Pharmaceutical Fraud in a Qui Tam World Patrick J. O ’ Connell Chief, Civil Medicaid Fraud Office of the Attorney General. How to Get A Million Dollars and Never Pay Taxes!. 1. First, Get a Million Dollars
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Pharmaceutical Fraud in a Qui Tam WorldPatrick J. O’Connell Chief, Civil Medicaid Fraud Office of the Attorney General
How to Get A Million Dollars and Never Pay Taxes! • 1. First, Get a Million Dollars • 2. When the IRS asks why you did not pay your taxes, you say: “I forgot”.
Get Yourself a Case • 1. MFCU • 2. Qui tam statute • 3. Types of pharma cases: • Pricing or “AWP” • Rebate • Off Label Marketing • PBM • Misrepresentation of efficacy or side effects
Chapter 36, Texas Human Resources Code -Automatic Trebles -Fees and Costs -Penalties from $1,000-$10,000 Per unlawful act -Automatic exclusion from program for minimum of 10 years
In-house Lawyers and Staff • Relator Lawyers and Staff • Outside Lawyers and Staff • Coordination with Other States Through NAMFCU
Get Some Money • Experts • Travel • Videographers • Court Reporters
State of Texas ex rel Ven-a-Care of the Florida Keys vs. Dey, Warrick & Roxane • Filed Sept. 2000 • Lawyers for Good Guys: 6 • Lawyers for Bad Guys: 10+ • > 130 Depositions • > 1,000,000 pages of documents • Travel to California, Tennessee, Ohio, New York, New Jersey, Connecticut, Alabama • Sanctions against each company for discovery abuse • Largest sanction ever awarded in Travis County for perjury in civil matter • Finally settled Nov. 2005 • Recovery of $55.6 million, including $12.7 million in fees and costs
State of Texas vs. Abbott Labs, Baxter & B. Braun • Filed May, 2004 • Settled with Baxter and B. Braun for $12.3 million • Texas Lawyers: 3 • Relator Lawyers: 3 • Abbott Lawyers: 15+ • Current Fees and Costs: $5 million + • Mandamus to Ct. App. twice • Mandamus to Tex. Supreme Ct. twice • Removed and Remanded
Results • Since 1999, recoveries of $217 million • Texas recoveries of $127 million • Federal: $58 million • State: $50 million • Relator: $19 million
Be Careful What You Wish For! • Current Caseload: 175 • Current Unsealed Cases: 4 • Current Lawyer Staffing: 10 • Requested Staff Increase Approved By Legislature: 27 • Requested Appropriation Approved for Biennium: $10.5 Million